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The objective of this study was to evaluate the efficacy of the endothelin receptor antagonist, bosentan, in patients with Raynaud’s phenomenon secondary to systemic sclerosis never treated with prostanoids and without digital ulcers. The study design is a preliminary, prospective open label trial. The patients recruited took one 62.5 mg dose of bosentan twice daily for 4 weeks, followed by 125 mg twice daily for 24 weeks. Of the 10 patients recruited, all completed the study. The reduction in Raynaud’s phenomenon attacks at week 24 from the baseline was statistically significant (Δ-1.3, P=0.0126). The Raynaud’s condition score showed a statistically significant improvement (Δ-1.4, P=0.0279), as did the visual analog pain scale (Δ-1.5, P=0.0016) at the 24th week. Bosentan appears to be effective and may be a valid alternative for the treatment of severe secondary Raynaud’s phenomenon for patients where prostanoids therapy is contraindicated or refused.

Objective: Hypereosinophilic syndromes are a heterogeneous group of uncommon disorders characterized by the presence of marked peripheral blood eosinophilia, tissue eosinophilia, or both, resulting in a wide variety of clinical manifestations, often without an identifiable cause. Churg-Strauss syndrome is a systemic vasculitis characterized by prominent peripheral eosinophilia, asthma and systemic involvement. The presence of mild to severe eosinophilia and systemic involvement raise the search of many trigger factor that need to be ruled out. Distinguishing CSS from idiopathic hypereosinophilic syndrome may be particularly challenging, especially in ANCA negative patients. Methods: The aim of the present study was to present a small case series of patients referred to a Rheumatology Unit for mild to severe eosinophilia and signs and symptoms of systemic involvement and to outline the clinical significance of molecular biology in the work-up of hypereosinophilia. Results: Eleven patients with moderate to severe peripheral eosinophylia, were referred to our Unit from 1996 to 2007. Female to male ratio was 7/4, mean age 40.54 (range 22-75). Three out of eleven patients resulted positive for molecular biology. The diagnosis of idiopathic hypereosinophylia was confirmed in one out of three on the basis of the clinical picture and bone marrow biopsy. Conclusions: Molecular biology may be useful in the screening and in the follow-up of a new hypereosinophylic patient.

Objective: To assess the personal exposure of workers employed at the coke-oven in a steel plant in Genoa., Design: Definition and implementation of a set of measurements for the environmental quality for the determination of PAH and benzene by means of personal sampling. Urinary determination of the metabolic substances given by benzo(a)pyrene and benzene was implemented for workers in different areas. Air pollution control was implemented by the firm during the years 1997, 1998, 1999 and 2001. Operative ways and sampling methods were previously discussed by our Operational Unit of Occupational Health and Safety Control (UO PSAL) together with the steel plant and its consultant Clinica del lavoro Luigi Devoto., Main Outcome Measures: First environmental pre-screening of personal exposure to the pollutant, March to April 1997; first campaign of environmental and biological measurements, March 1998; second campaign of measurements, February to October 1999 and March 2001., Results: The findings showed that among all workers, some groups were more exposed to PAH or benzene: "covers" employees, "change" employees, "loading" employees, "refrigeration and condensation" employees., Remarks: Relative shortage of scientific data, particularly with regards to the correlation risk/damage; our office operators were unable to collect parallel samples in order to validate results of environmental and biological analysis because of some local problems; problems in maintaining effectively the corrective actions taken; omissions and lack of standards in the process used for recording exposures. Lack of awareness, on the workers side, on their "right to know" about personal risk. Importance of a technical discussion, promoted by the Genoa Province Administration, intended for the exchange of information, for providing support to decisions, for comparing opinions about the effectiveness of the implemented precautionary measures and for interpreting results. The following interventions were carried out: revision of job procedures, job methods and Risk Assessment Document; training and information about the employees' risk, edited by the firm's Service for Prevention and Protection (SPP) and by a physician indicated by the firm; PPE (Personal Protective Equipment), revision by the SPP.

Unlabelled: It is known that heating at 50 degrees C for 10 minutes inhibits phosphate dependent glutaminase (PDG) activity of renal cortex, without any effect on gamma-glutamyl transpeptidase (gamma GT) and its phosphate independent glutaminase (PIG) activity. The effect of heating on PIG and total gamma GT activities was evaluated in renal cortex homogenates of rats both in normal acid-base equilibrium and in chronic metabolic acidosis (CMA). Homogenates were incubated in a medium containing glutamine 2 mM, no phosphate, at pH 7,40. PIG activity was measured as glutamate production and total gamma GT activity as ammonia production. In normal rats PIG activity was unchanged after heating, whereas a significant decrease of total gamma GT activity was observed (p less than 0,01). CMA caused an increase in both PIG and total gamma GT activity (p less than 0,01) and these increased to a further extent after heating. In both normal and acidotic rats the glutamate production/ammonia production ratio rose to about 1., In Conclusion: a) in the experimental setting used for this study PDG activity does not intervene in glutamate and ammonia production from glutamine; b) heating causes an inhibition of gamma GT activities, other than PIG, both in normal and in acidotic rats; c) in CMA heating increases PIG activity of gamma GT.